Provider Demographics
NPI:1962416768
Name:BOONE, JOHNATHAN (RRT, CPFT)
Entity type:Individual
Prefix:MR
First Name:JOHNATHAN
Middle Name:
Last Name:BOONE
Suffix:
Gender:M
Credentials:RRT, CPFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 DAVID CIR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-3254
Mailing Address - Country:US
Mailing Address - Phone:423-929-8200
Mailing Address - Fax:
Practice Address - Street 1:CORNER OF SIDNEY AND LAMONT
Practice Address - Street 2:JAMES H. QUILLEN- VAMC
Practice Address - City:(JOHNSON CITY) MOUNTAIN CITY
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCRT00000014252278P1006X, 227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2278P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary Function Technologist
Not Answered227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered